Radiology Digest – November 22, 2022

November 18, 2022

Radiology Digest: News from the week of November 22, 2022.
Taking Shape: New Postgraduate Degree Program for Technologists
By Dave Pearson | November 17, 2022 | Included in Radiology Digest – November 22, 2022

A university in the Lone Star State is readying to roll out a master’s degree program that will prepare grad students to work as radiologic “techs” in all 50 states.

The School of Health Professions at The University of Texas Health Science Center at San Antonio—aka UT Health San Antonio—says the advanced-degree program will launch in fall 2023.

Once off the ground, it will offer graduate-level training for techs-to-be in X-ray, CT and MRI.

Those who complete the curriculum will hold Master of Science degrees in imaging sciences.

The school suggests these individuals may go on to alleviate technologist shortages that have been straining much if not most of the U.S. healthcare system since the COVID-19 pandemic descended if not before.

An announcement posted by the school Nov. 14 quotes Laura Vasquez, PhD, MS, a UT Health assistant professor who will serve as the program’s director.

Vasquez says the program “will be the only one of its kind in the country—an entry-to-the-profession master’s multi-modality program that provides eligibility for three national certifications by the American Registry of Radiologic Technologists.”

The school says the MS in imaging sciences curriculum is awaiting full approval from the Southern Association of Colleges and Schools Commission on Colleges.

To read more, got to Radiology Business.


Lung Association Finds Low-dose CT Screenings Underused but Cancer Survival Improving
By Dave Pearson | November 16, 2022 | Included in Radiology Digest – November 22, 2022

More than 16% of eligible individuals get screened for lung cancer in Massachusetts. Only 1% do so in California. The national average is unfortunately closer to the latter extreme, at 5.8%.

These are among the key findings presented in the American Lung Association’s 2022 “State of Lung Cancer Report” published Nov. 15.

In announcing the report’s release, the group points out that, going by guidelines from the US Preventive Services Task Force, 14.2 million Americans should be screened annually with low-dose CT.

What’s more, for those who meet the USPSTF criteria for being at high risk, screenings are fully covered by Medicare and most private payers, the ALA reminds.

Noting that around 237,000 U.S. residents will be diagnosed with lung cancer this year, the association lays out some telling trends and numbers in the new report.

Full report available here.

To read more, go to Radiology Business.


Amazon Launches New Virtual Health Service
By Brock Turner | November 15, 2022 | Included in Radiology Digest – November 22, 2022

As Amazon waits for federal approval of its $3.9 billion One Medical acquisition, the tech giant is furthering its investment in healthcare with the launch of Amazon Clinic.
Amazon launched Amazon Clinic on Tuesday. The clinic will operate as a “virtual health storefront” offering users access to third-party telehealth providers.

Tuesday’s announcement comes on the heels of broader restructuring within the company.

Nathan Ray, a partner in consultancy West Monroe’s healthcare and life sciences practice, said Amazon’s big plans for healthcare are still unclear.

“It’s yet to be seen,” he said. “Are they just dabbling or is all of this going to be connected into something larger?”
Ray said large tech players that rely on cloud data for profit will each attempt to fold healthcare services into businesses differently.

Multiple outlets reported Amazon is planning to trim its workforce by 10,000 as early as this week. The layoffs—which would be the largest in the tech and e-commerce giant’s history—translate to roughly 3% of its corporate workforce.

Corporate layoffs, according to The New York Times, are targeted on the company’s Alexa and retail products, as well as human resources.

Amazon has been persistent in its healthcare push even after the company’s joint healthcare-specific venture with J.P. Morgan Chase and Berkshire Hathaway disbanded last year.

The results have been mixed. One month after the July acquisition of One Medical, Amazon announced it was shutting down its Amazon Care service at the end of the year. Amazon Health Services also comprises Amazon’s diagnostics business and pharmacy service, which includes an online pharmacy it launched in 2020 that grew out of the company’s acquisition of PillPack.

“It’s clear that … they’re not giving up on healthcare,” said Nathan Ray, a partner in consultancy West Monroe’s healthcare and life sciences practice after the company purchased One Medical in July. “They’re picking their points and they’re continuing to extend their fence-line.”

HealthTap, a virtual primary care provider, and SteadyMD, a telehealth provider operating in all 50 states, have listed services in several states and conditions.

Amazon said it will treat 20 non-urgent health conditions, ranging from sinusitis and urinary tract infections to acne, hair loss and birth control.

The cost of each consultation will vary, but many conditions have quoted prices around $40.

To read more, go to Modern Healthcare.


Anthem Blue Cross Axes $40K Bill After Patient Appeals on TikTok
By Rylee Wilson | November 15, 2022 | Included in Radiology Digest – November 22, 2022

Anthem Blue Cross originally denied a member’s appeal of a $40,000 bill for a tumor removal surgery — but the payer reversed course when the patient took to TikTok to dispute the bill, CBS Chicago reported Nov. 14.

Aaron McManus had surgery to remove a tumor from his kidney earlier this year. He received a $40,000 bill from Anthem for the cost of the surgery and hospital stay. 

After his first appeal was denied, the Oak Park, Ill.-resident posted a video to TikTok Sept. 8 titled “Anthem refused to pay for my cancer surgery while making billions in profit.” In the video, Mr. McManus said coverage for his surgery was deemed “not medically necessary” by the company, even though it was preapproved.  

In his video, Mr. McManus said he wanted to hear from Gail Boudreaux, CEO of Anthem’s parent company Elevance Health, about what she was doing to fix coverage denials. 

“I need to get a lot more cancer preventive care, so I don’t get other types of cancer, because I need to be here for my child,” he said in his video. “This is unacceptable and this coverage denial needs to stop.” 

His TikTok has garnered nearly 69,000 views as of Nov. 15. 
After posting the video, Mr. McManus received a call from Anthem, he told CBS. The company told him they had received hundreds of calls from viewers of the TikTok video. He then received a letter informing him his bill had been reversed from $40,000 to $61. 

To read more, go to Becker’s Payer Issues.

Hospitals and Health Systems Face ‘Dire’ Financial Situations
By Amy Baxter | November 15, 2022 | Included in Radiology Digest – November 22, 2022

Financial operations have turned dire for hospitals and health systems, according to a recent report that reviewed significant revenue losses and rising costs.

The new report, Hospital Double Whammy: Less Cash In, More Cash Out, was compiled by the Crowe Revenue Cycle Analytics (Crowe RCA) platform. It examined challenges healthcare providers are currently facing, with mounting cost pressures and declining revenue.

The report underscores other recent findings that hospitals are likely to report billions in losses by the end of the year thanks to a combination of environmental factors.

Healthcare revenue slashed
One of the biggest concerns for hospitals and health systems is a decline in revenue. That is partly due to the six-month lag in getting paid, a measurement of the expected case a healthcare provider collects within six months of the date of service. Since the onset of the COVID-19 pandemic, providers are seeing less revenue collection in a six-month period. 

In the summer of 2021, hospitals collected on average 97% of their expected cash within six months. In the same period in 2022, that dropped to 94%, and that 3% drop, coupled with a 9% increase in expenses, has led to a 12% negative impact on a health system’s finances, the report found.

“Even if a medical claim isn’t denied by payors, hospitals are struggling to collect expected revenue months after a service is provided,” Colleen Hall, managing principal of the healthcare services group at Crowe, said in a statement. “Between increasing pressures and mounting expenses, including rising employee costs brought about by inflation and staffing shortages, hospitals’ finances are taking a hit.”

Crowe also measured open accounts receivable (AR) to see how long claims are remaining open––and how long providers are waiting to get paid. The total proportion of receivables that have aged more than 90 days has grown to 37% in August 2022, up from 32% in January 2021. 

“Imagine the frustration of calling to check on the status of 37% of a paycheck and then waiting more than 90 days to receive it,” the report stated. “This 5-percentage-point jump directly affects the cost of care, but none of the cost is related to the actual cost of caring for the patient.”

In addition, healthcare providers are seeing higher rates of claims denials, when payors are processing claims, but not providing payment. In 2021, Crowe found an initial denial rate of 10.2%. That figure has reached 11% in 2022, which translates to 11,000 unpaid claims for an average size health system. Even a small increase in claims denials can increase the burdens on providers to resolve the denial and get paid. One of the biggest reasons for more denials is an increase of prior authorization requirements. Prior authorizations have increased from 1.5% of gross revenue in January 2021 to 2.5% in August 2022. 

To read more, go to Health Exec.
Learn more about what Zotec Partners can do for your radiology practice here.